Association between ventilation/perfusion scan outcomes and novel MAPH score in patients with suspected acute pulmonary embolism Asociación entre los resultados de la gammagrafía de ventilación / perfusión y la nueva puntuación MAPH en los pacientes con sospecha de tromboembolismo pulmonar agudo

Aydinbelge Dizdar N., TATCI E., Dursun A., Dizdar K., Inal G., Cinar A., ...Daha Fazla

Revista Espanola de Medicina Nuclear e Imagen Molecular, 2026 (SCI-Expanded, Scopus)

Özet

Background and objectives This study aimed to evaluate the association between the novel MAPH score, including mean platelet volume (MPV), age, total protein, and hematocrit, and lung ventilation-perfusion (V/Q) single photon emission computed tomography/computed tomography (SPECT/CT) scan findings in patients with suspected acute pulmonary embolism (APE). Material and methods Patients with suspected APE underwent V/Q SPECT/CT scintigraphy using Technegas and [99mTc]Tc-MAA. The patients were categorized into “APE-present” and “APE-absent” groups according to V/Q SPECT/CT scan findings. Using the Youden index, optimal cut-off values for MPV, age, total protein, and hematocrit were determined. Each parameter was then scored as 0 or 1 according to its respective threshold, and the MAPH score was calculated by summing these values. Results It included 161 patients (female/male: 119/42; median age: 68 years). Among them, 59 patients (36.4%) were categorized as “APE-absent” and 102 patients (63.4%) as “APE-present”. Patients in APE-present group were older and had a higher prevalence of hypertension, heart failure (HF), and chronic kidney disease (CKD) ( P <.05 for all). No significant differences were observed between the groups regarding cerebrovascular disease, coronary artery disease, diabetes mellitus, and anemia. Laboratory findings revealed that hemoglobin, hematocrit, MPV, urea, creatinine and MAPH scores were elevated in APE-present group ( P <.05 for all). ROC analysis demonstrated that a MAPH score ≥1.5 predicted APE with a sensitivity of 82.5% and a specificity of 46% (AUC = .724, P <.001). Conclusion According to our findings, the MAPH score demonstrated moderate performance in distinguishing APE in patients undergoing V/Q SPECT/CT. It was concluded that the likelihood of developing APE is higher in elderly patients and in patients with hypertension, HF, CKD or elevated hematocrit, MPV, and hemoglobin levels. These findings indicate that the MAPH score, when integrated with clinical and laboratory parameters, may improve the evaluation of patients with suspected APE by offering incremental value during clinical risk stratification and image assessment. Further studies are required to more comprehensively assess external validity and confirm these findings with additional imaging modalities.